Active NPI
Kent Jack Homnick, MD
- Anesthesiology Physician
- Pawleys Island, SC
National Provider Identifier
1427155241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD32690
- Practice address
- 42 Unity PL
Pawleys Island, SC 29585-6188 - Phone
- (843) 446-0937
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD32690 | SC | Primary |
Addresses
Primary practice location
42 Unity PL
Pawleys Island, SC 29585-6188
Mailing address
42 Unity PL
Pawleys Island, SC 29585-6188
Phone (843) 446-0937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 323292100 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD32690 | SC | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional Anesthesia Services PA | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Minnetonka, MN
- NPI 1073621850
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1427155241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 UNITY PL",
"city": "PAWLEYS ISLAND",
"state": "SC",
"postal_code": "295856188",
"telephone_number": "843-446-0937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 UNITY PL",
"city": "PAWLEYS ISLAND",
"state": "SC",
"postal_code": "295856188",
"telephone_number": "843-446-0937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOMNICK",
"first_name": "KENT",
"middle_name": "JACK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "SC",
"license": "MD32690",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "323292100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pawleys Island, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.